Skipper's Name______________________________________

Total number of people in party_________________________

Address___________________________________________

City______________________________________________

State______________ Zip____________

Home Phone_______________________________________

Cell Phone_________________________________________

Email_____________________________________________

Boat Year_______Length______Make__________________

Model________________Boat Name___________________

Land Display_______ In-the-Water Display______

RELEASE:

I understand and agree that the boats will be displayed and operated at the owners’ risk and the Wooden Boat Association, its officers, Bass Pro Shops, Holiday Inn Express, and event hosts and other parties involved shall not be responsible for any damage or loss thereto. It is further agreed that the boat owner and/or registrant relieves the foregoing organizations and organizers of any and all responsibility for accidents resulting in property damage or bodily harm which may occur during the event. My boat is properly registered and insured as required by law.

Signed:_________________________________ Date:__________________________